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NCLEX-RN Exam Questions - Part 30
1. A male client is started on IV anticoagulant therapy with heparin. Which of the following laboratory studies will be ordered to monitor the therapeutic effects of heparin?
A) Partial thromboplastin time
B) Hemoglobin
C) Red blood cell (RBC) count
D) Prothrombin time
2. A client is being discharged on warfarin (Coumadin), an oral anticoagulant. The nurse instructs him about using this drug. Which following response by the client indicates the need for further teaching?
A) 'I should shave with my electric razor while on Coumadin.'
B) 'I will inform my dentist that I am on anticoagulant therapy before receiving dental work.'
C) 'I will continue with my usual dosage of aspirin for my arthritis when I return home.'
D) 'I will wear an ID bracelet stating that I am on anticoagulants.'
3. A 68-year-old woman is admitted to the hospital with chronic obstructive pulmonary disease (COPD). She is started on an aminophylline infusion. Three days later she is breathing easier. A serum theophylline level is drawn. Which of the following values represents a therapeutic level?
A) 14 µ g/mL
B) 25 µ g/mL
C) 4 µ g/mL
D) 30 µ g/mL
4. A client is being discharged with albuterol (Proventil) and beclomethasone dipropionate (Vanceril) to be administered via inhalation three times a day and at bedtime. Client teaching regarding the sequential order in which the drugs should be administered includes:
A) Glucocorticoid followed by the bronchodilator
B) Bronchodilator followed by the glucocorticoid
C) Alternate successive administrations
D) According to the client - s preference
5. To prevent fungal infections of the mouth and throat, the nurse should teach clients on inhaled steroids to:
A) Rinse the plastic holder that aerosolizes the drug with hydrogen peroxide every other day
B) Rinse the mouth and gargle with warm water after each use of the inhaler
C) Take antacids immediately before inhalation to neutralize mucous membranes and prevent infection
D) Rinse the mouth before each use to eliminate colonization of bacteria
A) Partial thromboplastin time
B) Hemoglobin
C) Red blood cell (RBC) count
D) Prothrombin time
2. A client is being discharged on warfarin (Coumadin), an oral anticoagulant. The nurse instructs him about using this drug. Which following response by the client indicates the need for further teaching?
A) 'I should shave with my electric razor while on Coumadin.'
B) 'I will inform my dentist that I am on anticoagulant therapy before receiving dental work.'
C) 'I will continue with my usual dosage of aspirin for my arthritis when I return home.'
D) 'I will wear an ID bracelet stating that I am on anticoagulants.'
3. A 68-year-old woman is admitted to the hospital with chronic obstructive pulmonary disease (COPD). She is started on an aminophylline infusion. Three days later she is breathing easier. A serum theophylline level is drawn. Which of the following values represents a therapeutic level?
A) 14 µ g/mL
B) 25 µ g/mL
C) 4 µ g/mL
D) 30 µ g/mL
4. A client is being discharged with albuterol (Proventil) and beclomethasone dipropionate (Vanceril) to be administered via inhalation three times a day and at bedtime. Client teaching regarding the sequential order in which the drugs should be administered includes:
A) Glucocorticoid followed by the bronchodilator
B) Bronchodilator followed by the glucocorticoid
C) Alternate successive administrations
D) According to the client - s preference
5. To prevent fungal infections of the mouth and throat, the nurse should teach clients on inhaled steroids to:
A) Rinse the plastic holder that aerosolizes the drug with hydrogen peroxide every other day
B) Rinse the mouth and gargle with warm water after each use of the inhaler
C) Take antacids immediately before inhalation to neutralize mucous membranes and prevent infection
D) Rinse the mouth before each use to eliminate colonization of bacteria
1. Right Answer: A
Explanation: (A) Partial thromboplastin time is used to monitor the effects of heparin, and dosage is adjusted depending on test results. It is a screening test used to detect deficiencies in all plasma clotting factors except factors VII and XIII and platelets. (B) Hemoglobin is the main component of RBCs. Its main function is to carryO2from the lungs to the body tissues and to transport CO2back to the lungs. (C) RBC count is the determination of the number of RBCs found in each cubic millimeter of whole blood. (D) PT is used to monitor the effects of oral anticoagulants, e.g., coumarintype anticoagulants.
2. Right Answer: C
Explanation: (A) Using an electric razor prevents the risk of cuts while shaving. (B) Any physician or dentist should be informed of anticoagulant therapy because of the risk of bleeding due to a prolonged PT. (C) The client should be instructed to consult with his physician. Aspirin is avoided because it potentiates the affects of oral anticoagulants by interfering with platelet aggregation. (D) Identification bracelets are necessary to direct treatment, especially in an emergency situation.
3. Right Answer: A
Explanation: (A) The therapeutic blood level range of theophylline is 1020 mg/mL. Therapeutic drug monitoring determines effective drug dosages and prevents toxicity. (B, D)This value is a toxic level of the drug. (C) This value is a nontherapeutic level of the drug.
4. Right Answer: B
Explanation: (A) The client would not receive therapeutic effects of the glucocorticoid when it is inhaled through constricted airways. (B) Bronchodilating the airways first allows for the glucocorticoid to be inhaled through open airways and increases the penetration of the steroid for maximum effectiveness of the drug. (C) Inac- Inaccurate use of the inhalers will lead to decreased effectiveness of the treatment. (D) Client teaching regarding the use and effects of inhalers will promote client understanding and compliance.
5. Right Answer: B
Explanation: (A) It is sufficient to rinse the plastic holders with warm water at least once per day. (B) It is important to rinse the mouth after each use to minimize the risk of fungal infections by reducing the droplets of the glucocorticoid left in the oral cavity. (C) Antacids act by neutralizing or reducing gastric acid, thus decreasing the pH of the stomach. 'Neutralizing' the oral mucosa prior to inhalation of a steroid inhaler does not minimize the risk of fungal infections. (D) Rinsing prior to the use of the glucocorticoid will not eliminate the droplets left on the oral mucous membranes following the use of the inhaler.
Explanation: (A) Partial thromboplastin time is used to monitor the effects of heparin, and dosage is adjusted depending on test results. It is a screening test used to detect deficiencies in all plasma clotting factors except factors VII and XIII and platelets. (B) Hemoglobin is the main component of RBCs. Its main function is to carryO2from the lungs to the body tissues and to transport CO2back to the lungs. (C) RBC count is the determination of the number of RBCs found in each cubic millimeter of whole blood. (D) PT is used to monitor the effects of oral anticoagulants, e.g., coumarintype anticoagulants.
2. Right Answer: C
Explanation: (A) Using an electric razor prevents the risk of cuts while shaving. (B) Any physician or dentist should be informed of anticoagulant therapy because of the risk of bleeding due to a prolonged PT. (C) The client should be instructed to consult with his physician. Aspirin is avoided because it potentiates the affects of oral anticoagulants by interfering with platelet aggregation. (D) Identification bracelets are necessary to direct treatment, especially in an emergency situation.
3. Right Answer: A
Explanation: (A) The therapeutic blood level range of theophylline is 1020 mg/mL. Therapeutic drug monitoring determines effective drug dosages and prevents toxicity. (B, D)This value is a toxic level of the drug. (C) This value is a nontherapeutic level of the drug.
4. Right Answer: B
Explanation: (A) The client would not receive therapeutic effects of the glucocorticoid when it is inhaled through constricted airways. (B) Bronchodilating the airways first allows for the glucocorticoid to be inhaled through open airways and increases the penetration of the steroid for maximum effectiveness of the drug. (C) Inac- Inaccurate use of the inhalers will lead to decreased effectiveness of the treatment. (D) Client teaching regarding the use and effects of inhalers will promote client understanding and compliance.
5. Right Answer: B
Explanation: (A) It is sufficient to rinse the plastic holders with warm water at least once per day. (B) It is important to rinse the mouth after each use to minimize the risk of fungal infections by reducing the droplets of the glucocorticoid left in the oral cavity. (C) Antacids act by neutralizing or reducing gastric acid, thus decreasing the pH of the stomach. 'Neutralizing' the oral mucosa prior to inhalation of a steroid inhaler does not minimize the risk of fungal infections. (D) Rinsing prior to the use of the glucocorticoid will not eliminate the droplets left on the oral mucous membranes following the use of the inhaler.
80% DISCOUNT: NCLEX-RN PRACTICE EXAMS
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